RESUMEN
Losartan is a safe, effective long-term treatment for hypertension or posttransplant erythrocytosis (PTE) in renal transplant recipients. There were only a few studies in patients without PTE and their results were different. Starting from week 6 and continuing to the week 12 we observed a decrease in hemoglobin (Hb) and hematocrit (Hct) levels in patients without PTE. Anemia developed in 42.8% of the patients, and Hb levels increased after the withdrawal of losartan treatment. There was a significant decrease in Hct levels beginning from week 3 when compared with the control group. Our study suggests that losartan therapy can decrease Hb beyond its antihypertensive efficacy. Based on the capacity of losartan to decrease Hb and Hct, this drug should be carefully used in patients with preexistent anemia or low Hb levels.
Asunto(s)
Anemia/inducido químicamente , Hipertensión/tratamiento farmacológico , Trasplante de Riñón/efectos adversos , Losartán/efectos adversos , Adulto , Antihipertensivos/efectos adversos , Índice de Masa Corporal , Bloqueadores de los Canales de Calcio/uso terapéutico , Creatinina/sangre , Recuento de Eritrocitos , Femenino , Hematócrito , Hemoglobinas/metabolismo , Humanos , Hipertensión/etiología , Masculino , PolicitemiaRESUMEN
Bardet-Biedl syndrome (BBS) is a rare autosomal recessive disorder. End-stage renal failure has been reported as the most frequent cause of death in this disorder. There are few reports of kidney transplantation in these patients. Renal transplant patients are known to be at increased risk for the development of malignancies. Although a few patients with BBS have been described to develop malignant disease, there was no previous association with lymphoma. We report a 20-year-old patient in whom primary central nervous system lymphoma was diagnosed 20 months after renal transplantation.
Asunto(s)
Síndrome de Bardet-Biedl/complicaciones , Neoplasias del Sistema Nervioso Central/diagnóstico , Trasplante de Riñón , Linfoma/diagnóstico , Adulto , Antineoplásicos/uso terapéutico , Neoplasias del Sistema Nervioso Central/tratamiento farmacológico , Neoplasias del Sistema Nervioso Central/patología , Neoplasias del Sistema Nervioso Central/radioterapia , Terapia Combinada , Creatinina/sangre , Femenino , Humanos , Fallo Renal Crónico/cirugía , Linfoma/tratamiento farmacológico , Linfoma/patología , Linfoma/radioterapia , Metotrexato/uso terapéutico , Complicaciones Posoperatorias/diagnósticoRESUMEN
Pulmonary aspergillosis is a devastating disease. Early diagnosis allowing early treatment may improve the prognosis. However, this goal remains difficult to achieve. When the diagnosis is confirmed, it is often already too late. Despite antifungal treatment, the mortality rate is high. Patients with immunosuppression show a high mortality rate. We present five patients of ages ranging between 34 and 43 years who displayed aspergillus pneumonia between 1991 and 2000. All patients received cyclosporine, azathioprine, and prednisone for maintenance immunosuppressive therapy. Their ages ranged from 34 to 43 years with the onset of infection between 1 to 25 months posttransplant. In all cases, the infection was localized to the lungs. Standard methods of fungal culture and identification were used. No coinfections with tuberculosis or other fungi or bacteria were identified. Three cases were successfully treated but two patients showed deterioration despite appropriate therapy and died. Among patients with solid organ transplantation, lung, liver, and renal transplant patients are at the highest risk of developing aspergillus lung infections. A high degree of awareness and efforts for early diagnosis and therapy may improve the poor prognosis.